Tacrolimus is effective for lupus nephritis patients with persistent proteinuria.

Abstract

OBJECTIVES:

To evaluate the safety and potential efficacy of tacrolimus for the treatment of patients with lupus nephritis and persistent proteinuria.

METHODS:

A total of 23 Japanese patients with lupus nephritis (21 females/2 males) were enrolled in this study. Patients were administered tacrolimus at a dose of 2-3 mg once daily after the evening meal for 6 months. The dose of tacrolimus was unchanged throughout the study period. Concomitant prednisolone therapy was unchanged or gradually tapered, while other immunosuppressants were stopped at the start of tacrolimus treatment.

RESULTS:

Tacrolimus was well tolerated, and none of the patients developed adverse drug reactions that required discontinuation of the study. Daily urinary protein loss, the U-prot/U-creat ratio, and serum albumin were significantly improved after 4 months, 3 months, and 1 month of treatment with tacrolimus (p<0.05), respectively, and the improvement persisted until 6 months. The serum complement hemolytic activity (CH50), complement C3 level, and CRP level were also significantly improved after treatment with tacrolimus (p<0.05). Improvement of the U-prot/U-creat ratio was most prominent for patients who were in WHO class IV.

CONCLUSIONS:

Tacrolimus is safe and effective as maintenance therapy for patients with lupus nephritis, at least for 6 months. A larger randomised, controlled trial over a longer period is needed to confirm these results.

• Authors: A Uchino, H Tsukamoto, H Nakashima, S Yoshizawa, I Furugo, H Mitoma, K Oryoji, T Shimoda, H Niiro, Y Tada, T Yano, T Nonaka, R Oishi, K Akashi, T Horiuchi
• Journal: Clinical and experimental rheumatology (Clin Exp Rheumatol) 2010 Jan-Feb Vol. 28 Issue 1 Pg. 6-12 ISSN: 0392-856X [Print] Italy
• PMID: 20346231 (Publication Type: Clinical Trial, Journal Article, Multicenter Study)

Chemical References

• Complement C3
• Glucocorticoids
• Immunosuppressive Agents
• C-Reactive Protein
• Prednisolone
• Tacrolimus

Topics

• Adolescent
• Adult
• C-Reactive Protein (metabolism)
• Complement C3 (metabolism)
• Complement Hemolytic Activity Assay
• Drug Therapy, Combination
• Female
• Glucocorticoids (administration & dosage)
• Humans
• Immunosuppressive Agents (administration & dosage, adverse effects)
• Lupus Nephritis (drug therapy)
• Male
• Middle Aged
• Prednisolone (administration & dosage)
• Proteinuria (drug therapy)
• Tacrolimus (administration & dosage, adverse effects)
• Treatment Outcome
• Young Adult